• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.1
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• pp.23-30
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• 2012

Objectives : This study was conducted to investigate the prevalence of victims of bullying and the demographic characteristics of victims, and their related psychopathology, in a Korean nationwide sample of youths in middle and high school over a one month period. Methods : During the autumn of 2009, students in the 7th to 12th grades at 23 secondary schools participated in a nationwide, cross-sectional study. The study subjects completed the Adolescent Mental Health and Problem Behavior Screening Questionnaire-II (AMPQ-II) and Symptom Checklist-90-Revision (SCL-90-R). Based on the data acquired, descriptive statistics, correlation coefficients and multiple logistic regression analysis were performed. Results : Among the 3364 participants, 2272 (67.54%) completed the questionnaire. The prevalence of victimization was 28.9%. Male gender was positively associated with victimization, and grade level was negatively related to victimization. The AMPQ-II bullying score (Factor 4) was significantly (p<.001) and positively correlated to the AMPQ-II student total score (r= 0.50), Worry and thought (Factor 1 ; r=0.38), Mood and suicide (Factor 2 ; r=0.31), Academic and Internet-related problems (Factor 3 ; r=0.24), Rule violations (Factor 5 ; r=0.23), and AMPQ-II teacher total score (r=0.11). Somatization (r=0.23), Obsessive-compulsive behavior (r=0.24), Interpersonal sensitivity (r=0.30), Depression (r=0.33), Anxiety (r=0.26), Hostility (r=0.30), Phobic anxiety (r=0.22), Paranoid ideation (r=0.36), and Psychoticism (r=0.31) results from the SCL-90-R were also found to be positively related to the AMPQ-II bullying score, and remained significant after adjusting for age and gender. A total of 26% of the victims reported suicidal ideations as compared to 9% of non-victims over the month prior to the evaluation ($x^2$=119.595, df=1, p<.001). The multiple logistic regression analysis indicated that the AMPQ-II bullying score significantly increased the risk of suicidal ideation [Exp(b)=1.55, df=1, p<.001] after adjusting for age and gender. Conclusion : School bullying was highly prevalent among Korean middle and high school students. This study provided strong evidence that suicidal ideation and psychopathology were serious problems among the victims of bullying.

• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.265-284
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• 2001

The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.101-110
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• 2019

Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

• Journal of the Society of Disaster Information
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• v.9 no.4
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• pp.449-461
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• 2013

As the hydrofluoric acid leak in Gumi-si, Gyeongsangbuk-do or hydrochloric acid leak in Ulsan, Gyeongsangnam-do demonstrated, chemical related accidents are mostly caused by large amounts of volatile toxic substances leaking due to the damages of storage tank or pipe lines of transporter. Safety assessment is the most important concern because such toxic material accidents cause human and material damages to the environment and atmosphere of the surrounding area. Therefore, in this study, a hydrofluoric acid leaked from a storage tank was selected as the study example to simulate the leaked substance diffusing into the atmosphere and result analysis was performed through the numerical Analysis and diffusion simulation of ALOHA(Areal Location of Hazardous Atmospheres). the results of a qualitative evaluation of HAZOP (Hazard Operability)was looked at to find that the flange leak, operation delay due to leakage of the valve and the hose, and toxic gas leak were danger factors. Possibility of fire from temperature, pressure and corrosion, nitrogen supply overpressure and toxic leak from internal corrosion of tank or pipe joints were also found to be high. ALOHA resulting effects were a little different depending on the input data of Dense Gas Model, however, the wind direction and speed, rather than atmospheric stability, played bigger role. Higher wind speed affected the diffusion of contaminant. In term of the diffusion concentration, both liquid and gas leaks resulted in almost the same $LC_{50}$ and ALOHA AEGL-3(Acute Exposure Guidline Level) values. Each scenarios showed almost identical results in ALOHA model. Therefore, a buffer distance of toxic gas can be determined by comparing the numerical analysis and the diffusion concentration to the IDLH(Immediately Dangerous to Life and Health). Such study will help perform the risk assessment of toxic leak more efficiently and be utilized in establishing community emergency response system properly.

• Journal of Nutrition and Health
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• v.41 no.6
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• pp.561-572
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• 2008

Currently, Korea is facing dramatic nutrition transition among children, which may increase risk of degenerative diseases due to excessive intakes of fats, sugars and sodium. Promotion of eating healthier foods among children is difficult because the present nutrition label is not easily understood. Therefore, to promote healthier foods this study was aimed at developing guidance of standard amounts of high, medium and low levels of sugars, sodium, fats and other components contained in foods or drinks that are promoted to or formulated for consumption by children. Multipronged approach was used to collecting information, including key word searches in Medline and other databases, internet searches, reports from world organization, and contact of key individuals who work in organizations. We reviewed dietary reference intakes for Koreans, nutrient reference values, nutrient content claims of nutrition labeling, guideline daily amounts of United Kingdom, dietary guidelines and consumption data of nutrients, and selected components for labeling. And we decided goals of guideline daily amounts for children and nutrient criteria to underpin the high, medium and low content of each component. Then we collected data on processed foods sold at 12 middle schools and 11 high schools in Seoul, and classified processed foods into food category. Sales per one student per day were in the order of snacks, breads, and non-carbonated drinks. One hundred forty five mostly consumed products were selected and classified into criteria of high, medium and low total fat or sodium. Eighty five(58.6%) were classified into high fat food and only 11(7.6%) into high sodium food, in case that the base is chosen per 100 g or 100 mL. In conclusion, the nutrient criteria and choice of 100 g base, which we suggest in this study, need to be tested by simulation with more processed foods and refined in view of the practical issues suggested by stakeholders in future.

• Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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• 2000.11a
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• pp.44-63
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• 2000

Situated close to Heathrow Airport, and adjacent to the M4 and M25 Motorways, the site at Axis Park is considered a prime location for business in the UK. In consequnce two of the UK's major property development companies, MEPC and Redrew Homes sought the expertise of Intergeo to remediate the contaminated former industrial site prior to its development. Industrial use of the twenty-six hectare site, started in 1936, when Hawker Aircraft commence aircraft manufacture. In 1963 the Firestone Tyre and Rubber Company purchased part of the site. Ford commenced vehicle production at the site in the mid-1970's and production was continued by Iveco Ford from 1986 to the plant's decommissioning in 1997. Geologically the site is underlain by sand and gravel, deposited in prehistory by the River Thames, with London Clay at around 6m depth. The level of groundwater fluctuates seasonally at around 2.5m depth, moving slowly southwest towards local streams and watercourses. A phased investigation of the site was undertaken, which culminated in the extensive site investigation undertaken by Intergeo in 1998. In total 50 boreholes, 90 probeholes and 60 trial pits were used to investigate the site and around 4000 solid and 1300 liquid samples were tested in the laboratory for chemical substances. The investigations identified total petroleum hydrocarbons in the soil up to 25, 000mg/kg. Diesel oil, with some lubricating oil were the main components. Volatile organic compounds were identified in the groundwater in excess of 10mg/l. Specific substances included trichloromethane, trichloromethane and tetrachloroethene. Both the oil and volatile compounds were widely spread across the site, The specific substances identified could be traced back to industrial processes used at one or other dates in the sites history Slightly elevated levels of toxic metals and polycyclic aromatic hydrocarbons were also identified locally. Prior to remediation of the site and throughout its progress, extensive liaison with the regulatory authorities and the client's professional representatives was required. In addition to meetings, numerous technical documents detailing methods and health and safety issues were required in order to comply with UK environmental and safety legislation. After initially considering a range of options to undertake remediation, the following three main techniques were selected: ex-situ bioremediation of hydrocarbon contaminated soils, skimming of free floating hydrocarbon product from the water surface at wells and excavations and air stripping of volatile organic compounds from groundwater recovered from wells. The achievements were as follows: 1) 350, 000m3 of soil was excavated and 112, 000m3 of sand and gravel was processed to remove gravel and cobble sized particles; 2) 53, 000m3 of hydrocarbon contaminated soil was bioremediated in windrows ; 3) 7000m3 of groundwater was processed by skimming to remove free floating Product; 4) 196, 000m3 of groundwater was Processed by air stripping to remove volatile organic compounds. Only 1000m3 of soil left the site for disposal in licensed waste facilities Given the costs of disposal in the UK, the selected methods represented a considerable cost saving to the Clients. All other soil was engineered back into the ground to a precise geotechnical specification. The following objective levels were achieved across the site 1) By a Risk Based Corrective Action (RBCA) methodology it was demonstrated that soil with less that 1000mg/kg total petroleum hydrocarbons did not pose a hazard to health or water resources and therefore, could remain insitu; 2) Soils destined for the residential areas of the site were remediated to 250mg/kg total petroleum hydrocarbons; in the industrial areas 500mg/kg was proven acceptable. 3) Hydrocarbons in groundwater were remediated to below the Dutch Intervegtion Level of 0.6mg/1; 4) Volatile organic compounds/BTEX group substances were reduced to below the Dutch Intervention Levels; 5) Polycyclic aromatic hydrocarbons and metals were below Inter-departmental Committee for the Redevelopment of Contaminated Land guideline levels for intended enduse. In order to verify the qualify of the work 1500 chemical test results were submitted for the purpose of validation. Quality assurance checks were undertaken by independent consultants and at an independent laboratory selected by Intergeo. Long term monitoring of water quality was undertaken for a period of one year after remediation work had been completed. Both the regulatory authorities and Clients representatives endorsed the quality of remediation now completed at the site. Subsequent to completion of the remediation work Redrew Homes constructed a prestige housing development. The properties at "Belvedere Place" retailed at premium prices. On the MEPC site the Post Office, amongst others, has located a major sorting office for the London area. Exceptionally high standards of remediation, control and documentation were a requirement for the work undertaken here.aken here.

• Korean Journal of Community Nutrition
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• v.7 no.1
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• pp.121-129
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• 2002

Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

• Journal of Food Hygiene and Safety
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• v.32 no.5
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• pp.411-417
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• 2017

This study was conducted to establish the analysis method for the contents of choline in infant formulas and follow-up formulas by ion chromatograph (IC). To optimize the method, we compared several conditions for extraction, purification and instrumental measurement using spiked samples and certified reference material (CRM; NIST SRM 1849a) as test materials. IC method for choline was established using Ion Pac CG column and 18 mM $H_2SO_4$ mobile phase. The parameters of validation were specificity, linearity, LOD, LOQ, recovery, accuracy, precision and repeatability. The specificity was confirmed by the retention time and the linearity, $R_2$ was over 0.999 in range of 0.5~10 mg/L. The detection limit and quantification limit were 0.14, 0.43 mg/L. The accuracy and precision of this method using CRM were 95%, 2.1% respectively. Optimized methods were applied in sample analysis to verify the reliability. All the tested products were acceptable contents of choline compared with component specification for nutrition labeling. The standard operating procedures were prepared for choline to provide experimental information and to strengthen the management of nutrient in infant formula and follow-up formula.

• Journal of Food Hygiene and Safety
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• v.27 no.3
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• pp.271-276
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• 2012

This study intented to standardize the method for total polysaccharide, which is a functional marker for aloe vera gel in Korea. We used four lyophilized raw materials and commercial aloe gel products, certified as Health Functional Food by Korea Food and Drug Administration, including powder, solution, jelly, tablet and capsule, to optimize the analytical condition of dialysis and phenol-sulfuric acid reaction in polysaccharide analysis. The optimal conditions for polysaccharide analysis included 1 L water for dialysis and change 3 times for 24hr against 25 mL prepared sample solution. Validation test showed lower than 5% of coefficient of variation(CV) in intra-, interday validation in lyophilized raw materials and 4 types of commercial products. In inter-person and inter-laboratory validation with 4 persons from 4 different laboratories, CV(%) were 5.50 and 6.64 respectively. The linearity of polysaccharide analysis was assessed using 5 serial concentration of lyophilized raw materials(0.1, 0.2, 0.3, 0.4, 0.5%(w/v)). The results showed $R^2{\geq}0.995$ of high linearity. In the commercial aloe vera gel products, the results of reproductivity showed lower than 7.08% and revealed that the standardized method from this study ensured high precision for polysaccharide analysis.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.206-225
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• 2012

General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.